Cheatography
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Imaging findings + clinical features
This is a draft cheat sheet. It is a work in progress and is not finished yet.
RA - Clinical Features
- Young - middle aged females |
+ve RF/ RA latex |
Elevated ESR |
Anaemia |
Fever |
Fatigue |
Weight Loss |
Muscle Soreness |
Muscle Atrophy |
Fusiform/spindle like swelling |
Stiffness |
Can be variable |
Radiology
Synovial Oedema = Soft tissue Swelling |
Rheumatoid Nodule = Subcutaneous Soft Tissue Mass |
Cartilage Destruction = Uniform Loss of Joint Space |
Pannus Eroding Bone = Marginal Erosions "Rat bite" |
Intraosseous Pannus and Synovial Fluid Intrusion = Subchrondral Cysts |
Inflammatory Hyperemia = Juxtaarticular Osteoporosis |
Fibrous Tissue Metaplasia = Ankylosis |
Capsule, Tendon, Ligament laxity + rupture = Deformity (Swan neck & Boutonniere) |
Boutonniere = Flexion of the PIPs and Extension of the DIPs
Swan Neck = Extension of the PIPs and flexion of the DIPs
Mangement of RA
- NSAIDs |
- Corticosteroids |
- DMARDs |
- Conventional DMARDs |
- Biological Therapies (Anti-TNF) |
- Joint replacements if severe |
RA - Sites
RA affects the |
Hands, Wrist, Feet, Knee, Hip, Cx Spine |
In the Hands, RA affects the: |
MCPs, PIPs (1st), Carpals, ulnar styloid, Radiocarpal joint in a bilateral symmetrical fashion |
RA of the Cx Spine
- Atlanto-axial instability & impaction |
Dens Erosion |
- Pts who have RA in their feet and hands are more likely to suffer of Cx complications |
- Decreased Disc Height |
- Apophyseal Joint Disease |
- Spinous Process Erosion |
- Subluxation |
- Osteoporosis |
Juvenile RA
- Inflammatory Arthropathy <16 yo |
2 Main types + 3 subtypes |
RF + - Worst prognosis |
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RF - (Still's disease: Muscle wasting, fever, fatigue) |
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Classic - Systemic Organ Involvement |
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Polyarticular - Bilateral + Symmetrical- fewer systematic S&S |
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Pauciarticular/Monoarticular - <4 joints, Likes large joints |
Juvenile RA Findings
- Soft Tissue Swelling |
- Osteoporosis |
- Loss of Joint Space |
- Articular Erosions |
- Subluxations |
- Growth Disturbances + periostitis Ankylosis in children |
Systemic Lupus Erythematosis
- Rheumatoid Type (seropositive) |
- Females (child bearing) |
- ESR Elevated |
- LE cells present |
- ANA positive |
- Marked Subluxation |
Clinical Findings
- Malaise, Fever, Skin Rash, Arthralgias |
- Elevated ESR, ANF, LE , RF + |
Radiographic Findings
- Bilateral, Symmetric reversible deformities |
- Osteoporosis |
- Soft Tissue Atrophy |
- Increased Incidence of AVN in Hip |
- Hand most commonly affected |
- Increase in ADI |
- Ulnar Deviation |
- NO EROSIONS COMPARED TO RA |
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